Review finds physical therapy effective for dizziness, vertigo

People with vestibular disorders, which result from diseases or conditions affecting the inner ear, often experience problems with dizziness, balance, and movement. A new review of medical literature on vestibular rehabilitation, released by the Cochrane Collaborative, an independent international medical research and policy consortium, has found that there is a "growing and consistent body of evidence to support the use of vestibular rehabilitation for people with dizziness and functional loss as a result of UVPD" (unilateral or peripheral vestibular disorders).

UVPD are vestibular disorders that affect one side of the inner ear system, and affect only that area that lies outside the brain. According to the Cochrane Collaborative Review, these disorders can include vertigo, labyrinthitis, one-sided Meniere's disease, or problems triggered by surgery of the inner ear. Cochrane Collaborative research staff reviewed 27 studies of the effectiveness of physical therapy; some studies compared its effectiveness with other treatments, such as medication. While the Review researchers cautioned that some studies could not be compared because of variation in methods, those that could be compared showed evidence of physical therapy's benefits, particularly for treating dizziness and improving functioning in activities of daily living.

"The evidence is pretty compelling that physical therapy for inner ear disorders should be a top treatment choice, and some patients may even be able to avoid medications or surgery, depending on their specific situation," said Sue Yenoli, Canton-Potsdam Hospital Physical Therapist, who is certified in vestibular rehabilitation.

"A trained therapist can use a combination of exercises, education, retraining of the muscles controlling head and eye movement, and even simulations that help patients bring on symptoms and learn to control them. All these therapeutic options can be considered in a customized plan, based on the patient's underlying condition and specific symptoms," said Yenoli. "Vestibular therapy is also appropriate for people suffering from benign positional vertigo, which is the most common vestibular disorder," she

added. Physical therapists specializing in vestibular rehabilitation complete rigorous course work in assessment and treatment of disorders of the vestibular system in addition to their years of training in physical therapy.

"Most therapists also participate in special study sections that offer ongoing communication with other specialists nationally and continuing education as part of their membership in the American Physical Therapy Association," said Yenoli.

According to the National Institute on Deafness and other Communication Disorders and the Vestibular Disorders Association, approximately 4 percent or eight million Americans report a chronic problem with balance, and another 1.1 percent report problems with dizziness alone. Balance disorders are a leading cause of falls among the elderly, resulting in billions of dollars in potentially avoidable healthcare costs annually.

The Cochrane Collaborative Review is one of over 4,000 medical literature reviews updated on an ongoing basis by volunteer and paid experts. Founded in 1993, the Cochrane Collaborative, which produces the Reviews and other medical practice and policy guidance, is a non-partisan global network of healthcare organizations and researchers primarily interested in promoting the use of rigorous, evidence-based scientific methodology in assessments of medical interventions. More information is available at www.cochrane.org.

For more information about vestibular rehabilitation, patients should contact their primary care practitioner, or CPH Physical Rehabilitation in Potsdam, at 315-261-5460.